Over its first century, Duke has established itself as a nationally leading academic and research institution.
Today, the University and health system have also become significant economic stimulants for their home city and the broader North Carolina region. Together, they stand as the largest employer and landowner in Durham and the second-largest private employer in the state.
But despite its contributions to the local economy, some residents have criticized Duke’s 501(c)(3) tax-exempt status and alleged it has played a role in Durham’s rising unaffordability.
In an April INDY Week editorial, City Council Member Nate Baker called for Duke to make direct payments to the City of Durham “in lieu of property taxes,” which he argued would “ensure that the tax burden is more fairly distributed” and “transform Durham for years to come by providing millions of dollars to support crucial city and county services.”
Duke does direct a number of community engagement initiatives through the Office of Durham and Community Affairs, ranging from college advising services to investment in affordable housing construction. However, Baker argued that such efforts are part of the University’s responsibility to be “a good neighbor and partner to the city” and that additional financial support is necessary for Duke to “pay its fair share.”
Such a move would mirror actions by peer institutions including Yale University, Harvard University and the Massachusetts Institute of Technology.
Since then, a “Duke Respect Durham” movement has emerged in support of Baker’s proposal, using the University’s Centennial as an impetus to advocate for a “democratic partnership” between Duke and Durham. The cause gained the support of several local unions and community organizations, including the Durham Association of Educators, the Durham Workers Assembly and the Sunrise Movement Durham Hub.
Duke recently established a new associate vice president for economic development position to “lead and create critical programs to positively impact economic opportunity across the Duke and Durham communities.” Adam Klein was selected to assume the role in January and began his term April 1.
Amid such calls for Duke to reexamine its financial relationship with its neighbors, The Chronicle examined recent reports measuring Duke’s economic impact on the city and state it calls home.
The last report calculating Duke’s overall economic impact on the “City of Medicine” — a nickname for Durham inspired by Duke’s extensive health system — and the greater Durham county was conducted by Duke’s Office of Public Affairs. The study found that total spending in Durham by the University and health system for goods and services, total money spent locally by students and visitors, and total salaries and benefits received by Duke employees who are Durham residents during fiscal year 2006-07 totaled $3.4 billion.
Since then, Duke State Relations has published three annual Duke in North Carolina reports measuring the impact of the University, Duke Health and Duke LifePoint Healthcare across the state. However, these reports lack some of the monetary figures detailed in earlier economic impact calculations.
Employment
Since 2018, Duke has consistently been the largest employer in Durham County and the second-largest private employer in North Carolina behind Walmart. The 2024 Duke in North Carolina report shows that Duke University and its associated health system provide full or part-time jobs to approximately 44,500 people in North Carolina, paying $4 billion in salaries and wages annually.
A significant amount of the University’s spending remains local, with over $1.1 billion spent annually on goods and services from vendors and contractors based in North Carolina.
Notably, many Duke graduates choose to stay in North Carolina — home for 34,000 alumni and the top destination for Class of 2023 graduates — contributing to the growth of the labor force. Startup companies founded at Duke also often stay in-state, with 10 of the 15 that launched in FY23 remaining headquartered in North Carolina.
The economic contributions of current students and visitors is not tallied in newer reports, but figures by NAFSA: Association of International Educators — a nonprofit focused on international education — estimated that international students at Duke University contributed $273.5 million to the North Carolina economy during the 2022-23 academic year — the largest amount of any institution of higher education in the state.
The “economic benefit” estimate was calculated using tuition and living expense data for international students from the U.S. Department of Education. According to data from the U.S. Department of Commerce, the students’ investment also created or supported over 3,119 jobs during the 2022-23 academic year — the largest boost of the 47 colleges and universities measured and more than twice the figure for second-ranked North Carolina State University at 1,502 jobs.
Education
Duke’s role as a post-secondary institution has offered educational opportunities for many state residents. While the University currently receives no funding from the state government, North Carolina is the most heavily represented state among Duke’s undergraduate student population.
In fall 2023, the University began providing full tuition grants to students from the Carolinas with family incomes of $150,000 or less. Many expect the move to increase the enrollment of eligible students over the next five years, resulting in an additional annual investment by Duke of $6 to $7 million in financial assistance for North and South Carolinian students.
Yet, Duke is not alone in boasting a high percentage of homegrown students. Many of the University’s peer institutions also share high in-state student enrollment rates, including the University of Pennsylvania, Vanderbilt University and Harvard.
Public health and medicine
As a research institution, Duke spends heavily in research and development categories. The University spent over $1.39 billion on R&D in FY23, the ninth-largest sum in the nation.
In spite of research advancements resulting from the investment, the monetary impact of such spending on Durham and North Carolina is unclear.
Duke University Health System operates three major hospitals and over 400 clinics across the state. For FY23, 92% of the health system’s inpatient 67,000 inpatient discharges were North Carolina residents, while 96% of its 2.8 million outpatient encounters involved North Carolinians.
The health system also partners with LifePoint Health to extend its services to rural regions of North Carolina. According to the joint venture’s 2023 Community Benefit Report, Duke LifePoint had a total economic impact of $991.3 million on the state. Duke LifePoint provided nearly $344 million in charity and uncompensated medical care last year and employed around 5,860 North Carolina residents in 2023, totaling over $524 million in payroll.
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Ana Despa is a Pratt sophomore and an associate news editor for the news department.